Malnutrition in Eastern Sudan
A group of children are stood around a lone building in the dusty, arid land of North Delta, near Kassala. On the step of the building, shaded from the heat of the midday sun, sit their mothers, with small babies swaddled in their toobs on their lap. Behind them, a health workers weighs a child. These semi-nomadic people, struggling to live in this desert environment, were all here to benefit from the work of Hamid al-Taib Hamid & his team of health workers working at this outpost. Dr. Mohammed Jalaleldeen, a UNICEF nutrition consultant in Kassala, describes him as “the most motivated person I have met, always happy”.
“Ashkira”, as he is known locally, is working at one of the many Outpatient Therapeutic Program (OTP) that have been established in Eastern Sudan over the past year or so, rolling out community management of acute malnutrition (CMAM) using Plumpy’Nut, described as UNICEF’s “star product”. CMAM has been in Sudan since 2001, but has only recently been approved for use in regions outside Darfur. Dr. Jalaleldeen had previously worked in the conflict-torn region, but describes malnutrition in Eastern Sudan as worse than there. Generations have grown up here malnourished, and so the situation is seen as normal.
Some of the people using this clinic survive on one meal a day‚asida, the Sudanese equivalent of porridge‚ and drinking cows’ milk. There are traditions in this particular community where people don’t wash their clothes or themselves, thus exacerbating problems of hygiene. As well as providing treatment for malnourishment, health workers here advise the community about sanitation, hygiene, and how to supplement their diet. “Now people are [washing their hands], I have noticed a decrease in illness amongst the children” says Firial Osman, a volunteer at the Arooma Primary Health Care Unit, an hour’s drive away.
The success of the clinics is not only visible in the statistics of treated cases. A visible improvement in weight, height and even behaviour are changing the lives of these children.
Before, the children looked depressed and had no colour. Now they look more active. Before, they were crying all the time, and now they have begun playing.
— Hamid al-Taib Hamid
This work has all been carried out with close interaction with the state Ministry of Health. Interviewing Dr. Artor, the PHC Director for the ministry, he explains that the programs have been very well accepted by the communities here, with high political commitment of the Wali and the minister of health. But they still face a lot of challenges. In Blue Nile State, for example, vast swathes of the state are cut off for months at a time with the onset of the rainy season. Supplying goods, as well as monitoring the progress of the centres, is a great difficulty.
The results on the ground, however, are stunning. As I talk to Ashkira, a box of empty Plumpy’Nut wrappers sits behind him, testament to the children his team have treated. These centres are changing‚ and saving, people’s lives.